Indemnity Form

PAST VS PRESENT 2009 INDEMNITY FORM

To be completed and signed by applicant/guardian. All applicants must submit the following indemnity form. I, _________________________ holder of NRIC___________________, confirm that I/ my child*____________________ holder of NRIC ________________will attend and fully participate in Past Vs Present 2009 on the 19th September 2009. I understand that I/my child* will have to cooperate fully with the PvsP committee and diligently comply with all safety regulations. I/ my child* shall not hold the PvsP Committee and Hwa Chong Institution responsible for any damage to or loss of property or any injury or loss of life which may be sustained by me during the Past vs Present carnival or arising from any cause in connection with the carnival.

Date: __________________________

__________________________________

Name of Applicant / Guardian*

_____________________________

Signature

_____________________

NRIC

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*Delete where not applicable